96b Deep Massage: Guided Full Body 96b Deep Massage: Guided Full Body - - PowerPoint PPT Presentation

96b Deep Massage: Guided Full Body

96b Deep Massage: Guided Full Body

Class Outline 5 minutes Attendance, Breath of Arrival, and Reminders 10 minutes Lecture: 25 minutes Lecture: 15 minutes Active study skills: 60 minutes Total

96b Deep Massage: Guided Full Body

Class Outline

Touch Assessment:

• 97b Deep Massage: Touch Assessment
• Bring your grading sheet for evaluation A: 89

Exams:

• 98a Practice MBLEx (100 questions in 2 hours)

Preparation for upcoming classes:

• 97a Special Populations: Cancer
• Packet K: 41-58.
• 97b Deep Massage: Touch Assessment
• Prepare to massage 1 assigned body area such as the:
• Posterior upper body
• Posterior lower body
• Anterior lower body
• Anterior upper body
• Neck, face, and scalp
• Your receiver will be an instructor who will give you verbal feedback which you will

write down and turn in to get credit for the assessment.

• Packet A: 81-82 and 89-90.

Classroom Rules

Punctuality - everybody’s time is precious

• Be ready to learn at the start of class; we’ll have you out of here on time
• Tardiness: arriving late, returning late after breaks, leaving during class, leaving

early The following are not allowed:

• Bare feet
• Side talking
• Lying down
• Inappropriate clothing
• Food or drink except water
• Phones that are visible in the classroom, bathrooms, or internship

You will receive one verbal warning, then you’ll have to leave the room.

96b Deep Massage: Guided Full Body

Client Prone Note: Add in brief palpations and integrative petrissages, rocking or resting strokes, as intuitively called for. Monitor for working signs – LISTEN. Fists Down Erectors Nine Points Ironing Up Erectors Levator Scapula Posterior Neck Trapezius Semispinalis Capitis Multifidus/Rotatores Fists Down Erectors Gluteus Maximus Hamstrings Gastrocnemius/Soleus

Supine Position Half Moon Vector through the Legs Tensor Fasciae Latae, Gluteus Medius, and Gluteus Minimus Iliotibial Band Rectus Femoris Peroneus Longus Tibialis Anterior Half-Moon Vector through the Legs Rectus Abdominis Pectoralis Major Biceps Brachii Triceps Brachii Trapezius Scalenes Facial muscles Epicranius Half-Moon Vector through the Neck Half-Moon Vector through the Legs

Fists Down Erectors

• Center yourself – in body, mind, and emo9on
• Take out looseness - pressing easily in towards ribs 1-3
• Take up the slack – engaging/“pre-stretching” inferiorly
• Add addi9onal vectors- following the erectors down the back

with a deep effleurage using your loose fists

• Sustain the gesture- so it is one long helpful experience

(make it quicker and lighter the first pass)

• Monitor for working signs or (signs of too much!)
• Make sure to liP up the liQle finger sides of your hands as you

get to the lower lumbar/sacral area – go down to at least S 3

• Clearly disengage
• Then you can do a “return” stroke if you please.
• Repeat as many as 3 9mes

Nine Points

• Palpate for tension in -
• 1. the side of iliocostalis

– Just above the iliac crest – Halfway between it and the 12th rib – Just below the 12th rib When you palpate, if you feel tension, press into the tension and hold it – crea9ng a fulcrum

• 2. Follow the same steps into mul9fidus

Just above the iliac crest; halfway between the iliac crest and the 12th

rib; Just below the 12th rib. When you palpate, if you feel tension, press into the tension and hold it – breathe! Create fulcrums as needed.

• 3. Follow the same steps into quadratus lumborum

Just above the iliac crest; halfway between the iliac crest and the 12th rib; Just below the 12th rib. When you palpate, if you feel tension, press into the tension and hold it. Create fulcrums as needed.

Ironing up the Erectors #1

Ironing up the Erectors #2

• 1. Take out the looseness gently – around rib 10-11
• Take up the slack, pre-stretching superiorly
• Add addi9onal vectors “ironing” up to the level of the scapula’s inferior

angle

• Clearly disengage
• 2. Switch hand posi9ons – so between scapula you work with three fingers.

Let your other hand, cup the front of the humerus and gently trac9on the anterior shoulder girdle open.

• Take out the looseness around T 8
• Take up the slack pre-stretching superiorly
• Add addi9onal vectors “ironing up” to the level of the 1st rib, then hook

your fingers and trac9on laterally through the trapezius belly above the scapula

• Cleary disengage
• - #2 oPen is done 2 or even 3 9mes

Levator Scapula

Seated - Posi9on your chair at a slight diagonal and above the opposite shoulder – so you face the one you’re going to be working with

• Find the inser9on of levator scapula at the superior angle of the scapula
• Press in taking out the looseness with your thumb
• With your other hand, pull the lateral margin of the scapula toward you,

adding an addi9onal vector (which will get the thumb in more deeply)

• Sustain the gesture (monitor for working signs)
• When ready, let go of hand on lateral scapula
• Place both thumbs on levator inser9on/superior angle of scapula
• Create a lengthening fulcrum with an inferio-lateral lengthening
• Clearly disengage

Trapezius – “liPing the curtain”

Seated - This is preparatory move for deeper work – so - not too much pressure!

• Take out the looseness at the lateral margin of the

trapezius

• Take up the slack pressing toward the centerlne
• Add addi9onal vectors, sweeping the thumb through

the trapezius, ending at the spinous process

• Do this 4-5 9mes – each 9me higher than the last.

Semispinalis Capi9s

Seated –

• Star9ng at the level of C 7 – press medially into the

belly of semispinalis capi9s – take out the looseness

• If you feel tension, take up the slack, pressing into

the tension

• Then add addi9onal vectors, holding the point while

the client lets go from inside out

• Cleary disengage
• Do this at 4-5 vertebral levels, each successively

higher, the last being just inferior to the occiput

GLUTEUS MAXIMUS

• Place your forearm (near the elbow) onto the apex of

gluteus maximus

• Take out the looseness (pause)
• Take up the slack, with a sa9sfying level of pressure

(pause)

• Breathe, relax and give the person the giP of 9me in which

to let go from inside out (you’re “in the box)

• Clearly disengage
• You may choose or not to do some introductory or

integra9ng lighter work)

GLUTEUS MAXIMUS (CONT’D)

• With loose fist, take out the looseness just beneath the iliac crest and

just lateral to the sacrum (pause)

• Take up the slack, trac9oning inferiorly without moving (pause)
• Add addi9onal vectors with a moving fulcrum inferior and a lateral

through glutueus max. to its inser9on about 3/4 of the way down the femur (i.t. band)

• Do two more moving fulcrums following the same route but each

star9ng a fist’s width lateral to the last star9ng point (Op9on - you can do the third pass, with the heel of one hand on the sacrum, generally lengthening the spine, and the other loose fist, palm facing up going down the side of the pelvis, easing up over the greater trochanter and again about 3/4 down femur)

HAMSTRINGS

• With loose fist, nestle into boQom of ischial tuberosity
• Take up the slack with inferiorward trac9on, not moving
• Add addi9onal vectors with a moving fulcrum going down

biceps femoris ending near the inser9on on the fibula

• Do a similar fulcrum using the ridge of the knuckles of

your loose fist in the “valley” between the medial and lateral hamstrings (easy over the back of the knee)

• Do another moving fulcrum with the flat of the loose fist

down the “semi’s” ending at the back of 9bia

GASTROCNEMIUS/SOLEUS (AKA TRICEPS SURAE)

• Using supported forearm (see which is more comfortable) take out

the looseness pressing into gastrocnemius/soleus just beneath the knee ¶

• Take up the slack with gentle inferiorward trac9on ¶
• Add addi9onal vectors following the shape of triceps surae down to

the inser9on on the calcaneus important - slow way down as you work through the calcaneal tendon and then onto the posterior surface of the calcaneus. Tendons change more slowly than muscles bellies. Also you here have the ability gently to engage the whole person (as in the half moon vector through the legs).

Half Moon Vector through the Neck

Seated -

• Clearly contact the inferior surface of the occiput with your

fingers – take out the looseness

• Take up the slack with a gentle superior-ward opening

through the neck/upper spine

• Add addi9onal vectors (the “half moon”) by gently bringing

your fingers more toward yourself – the chin should, as a result slightly nod downward maybe a half inch.

• Hold it, Hold it, Hold it. Give the client the giP of 9me to let

go of physical tension through the head, neck and whole self.

• Let go of the half-moon.
• Set the head down, leaving the client in length.
• Clearly disengage.

Half Moon Vector through the Legs

Center yourself and your client (gently see if you can get the legs not to be too “turned out”)

• Contact the calcanei and calcaneal tendons with your

hands – take out the looseness between your hands and the calcanei and Achilles tendons.

• Take up the slack from the whole body and the

Achilles tendons.

• Add addi9onal vectors (the ”half moon”) by adding

slight addi9onal length while simultaneously going down, then back up (so it’s a clear and simple curved pull). You can also li+ the legs up a li1le if it feels be1er for the client or for your back.

• Hold it, Hold it, Hold it.
• Monitor for working signs (but don’t wait for one!)
• Clearly disengage, sepng the legs down in length.

• TENSOR FASCIA LATA, GLUTEUS MEDIUS AND MINIMUS
• Kneeling or seated -
• Place your thumb just behind the ASIS at the origin of tensor fascia

lata and place the heel of your other hand about 2/3rds of the way down the femur posterior to the i.t. band.

• Take out the looseness in the point and the hip (with pressure into

t.f.l. and gentle medial rota9on thru hip)

• Take up the slack adding a bit more pressure and rota9on
• Hold it, Hold it, Hold it
• Clearly disengage
• Repeat 8 9mes - following the routes shown in the illustra9on

You will have created fulcrums in three lines, each ending at the top of the greater trochanter

RECTUS FEMORIS/VASTUS INTERMEDIUS

• Take out the looseness in the front of hip (origin of rectus

femoris)

• Take up the slack with a sta9c trac9on
• Addi9onal vectors inferiorly through the belly of rectus

femoris (you can also visualize vastus intermedius)

• Well before gepng there, put your palm gently on the

patella to reassure your client

• Clearly disengage

• Place both thumbs between the patella and 9bial

tuberosity - take out the looseness

• Sta9c trac9on - medial and lateral
• Add addi9onal vectors making the shape of a smile with a

moving fulcrum medial and lateral beneath the patella ¶

• Place both thumbs just above the patella at the

centerline - take out the looseness

• Take up the slack pulling laterally and medially w/o moving
• Add addi9onal vectors with a moving fulcrum medial and

lateral just above the level of the patella

ILIOTIBIAL BAND

• Star9ng just beneath the greater trochanter and just

posterior to I.t. band, take out the looseness pressing medially

• Turn thumb pads facing up - take up the slack
• Make a rainbow shape with the thumbs, gently stretching

the I.t. band up toward the sky

• Hold it, Hold it, Hold it
• Clearly disengage
• Repeat about 4-5 more 9mes un9l the last fulcrum about

an inch above the knee

PERONEUS LONGUS AND BREVIS (FIBULARIS) As with ilio9bial band, create fulcrums through peroneus longus and brevis (aka) fibularis

• Start just below the fibular head and do a series of about

5 fulcrums with the last one about an inch above the lateral malleolus

TIBIALIS ANTERIOR

• Take out the looseness with the loose fist just below the

patella and immediately lateral to the 9bia

• Take up the slack with a sta9c trac9on
• Add addi9onal vectors with a moving fulcrum along the

whole length of 9bialis anterior (ease up in front of the ankle but do gently follow out its full length to the medial cuneiform/instep)

Half Moon Vector through the Legs

Center yourself and your client (gently see if you can get the legs not to be too “turned out”)

• Contact the calcanei and calcaneal tendons with your hands –

take out the looseness between your hands and the calcanei and Achilles tendons.

• Take up the slack from the whole body and the Achilles

tendons.

• Add addi9onal vectors (the ”half moon”) by adding slight

addi9onal length while simultaneously going down, then back up (so it’s a clear and simple curved pull). You can also li+ the legs up a li1le if it feels be1er for the client or for your back.

• Hold it, Hold it, Hold it.
• Monitor for working signs (but don’t wait for one!)
• Clearly disengage, sepng the legs down in length.

Rectus Abdominis - #1

• R- side – gently place whole palm of r. hand on belly of

rectus ab so your middle finger is in the middle of the belly of the muscle about 2 in. beneath level of navel

• Let leP hand rest on right hand
• Press gently with leP hand fingers, so you take up the

looseness in the belly of the muscle – pause

• Press just a liQle more, taking up the slack
• Relax yourself – your breathing/your abdomen, etc. –

maintain the pressure – let client let go from inside

• ut, feeling free to breathe. Hold it, hold it, hold it.
• Clearly disengage
• Do a series of similar fulcrums – each about 1-1.5

inches higher – so you do about 5 fulcrums.

• For the last one into the belly you can add addi9onal

looseness and ease, by gently pulling lower ribs down.

Rectus Abdominis - #2

• Change your body posi9on. Standing further down body in

more of a lunge posi9on

• Place leP hand alongside ribs, place right hand, fingers

gently curved, between ribs 7 & 8 lateral to xiphoid process

• Press gently into body with both hands, take up the

looseness

• Gentle stretch up without movement, take up the slack
• With right hand, do a slow, moderately deep effleurage

adding addi9onal vectors up rectus abdominis’ tendons to R5 (you’re contac9ng sternum, costo-sternal joints and rib car9lage next to the joints)

• With men, con9nue that up to undersurface of clavicle
• With women, at R5 bring upper hand to touch lower, and

pull up with upper hand, so you needn’t work between the breasts at any 9me. Switch hands back around R2 up to undersurface of clavicle.

Pectoralis Major – Part #1

• With loose fist take out looseness contac9ng

sternum and costal car9lages 1-4.

• Take up the slack pulling laterally w/o moving.
• Add Addi9onal vectors with moving fulcrum

laterally through pectoralis major – go to space between ribcage and arm

• Disengage

Pectoralis Major (and deltoid) – Part #2

• Placing both fists medial to the anterior

deltoid, take out the looseness

• Pull them laterally without moving (arm may

start to rotate laterally)

• Add addi9onal vectors with a moving fulcrum

through the anterior and acromial fibers of the deltoid (and deep to it – pectoralis major)

• As you come across deltoid, go as far as the

table surface, but ease up a bit, don’t pinch

• Clearly disengage

Trapezius

• Take out looseness bilaterally, just lateral to neck in

belly of trapezius, find tension (if it’s there) and press

• nto it
• Take up the slack, press into the tension
• Add addi9onal vectors, relaxing your breath and

lepng your body rest in – take out addi9onal looseness as they let go

• Hold it, hold it, hold it
• Monitor for working signs
• Clearly disengage
• Repeat these fulcrums bilaterally about 3 more

9mes, each 9me about a ½ to 1 inch more lateral

Biceps Brachii

• Place loose fist about ¼ way down the biceps

– take out the looseness

• With gentle pull distally, take up the slack
• Add addi9onal vectors with moving fulcrum

down to inser9on at radial tuberosity

• Clearly disengage

Triceps Brachii

• Posi9on arm comfortably overhead (can rest it
• n a pillow or your thigh)
• Take out looseness, with loose fist, close to

scapular aQachment

• Take up the slack pulling distally
• Do moving fulcrum adding addi9onal vector

down length of triceps – slowing down and ending at olecranon process

• Clearly disengage

Scalenes

• R- side – place r. middle finger, supported by the
• thers, just lateral to SCM just over clavicle.
• Take out the looseness.
• Take up the slack.
• Instruct the client to liP their chin, then turn their

head slowly to the leP, while you simultaneously draw your fingers around the neck at the level of C7, going all the way to the spinous process of C7

• Have them come back to center, then lower chin
• Repeat those steps at interface at the level of C4

and then at the level of C1.

Facial Muscles

• Therapist seated:
• Place thumbs at the center just below the hairline
• Take out the looseness pressing posteriorly – visualize

that you’re engaging the cranio-facial periosteum, not the skin

• Take up the slack with a sta9c stretch to the sides
• Use your thumbs to create a moving fulcrum just

underneath the hair line, then, as a return “nerve” stroke underneath, behind the ears, and back to the next lowest place about 1.5 lower on the face

• Repeat about 8 more 9mes to cover the whole face,

ending with a pass on the undersurface of the mandible

• Switch to fingers any9me they’re easier to work with.

Epicranius (occipitofrontalis)

• Place your fingers behind the ear near the base of the

temporal bone

• Take out the looseness, visualizing you’re contac9ng the

periosteum

• Add addi9onal vectors, mobilizing the cranial 9ssues with

somewhat deep semi-circles

• Disengage; then come up about 1.5” and repeat
• Do about four passes star9ng behind, then over the ear
• Place your fingers close to the centerline near the base of the
• ccipital bone.
• Repeat the steps above, making 5-6 semicircular fulcrums

near the center line, ending finally just above hairline on the frontal bone

Half Moon Vector through the Neck

Seated -

• Clearly contact the inferior surface of the occiput with your

fingers – take out the looseness

• Take up the slack with a gentle superior-ward opening

through the neck/upper spine

• Add addi9onal vectors (the “half moon”) by gently bringing

your fingers more toward yourself – the chin should, as a result slightly nod downward maybe a half inch.

• Hold it, Hold it, Hold it. Give the client the giP of 9me to let

go of physical tension through the head, neck and whole self.

• Let go of the half-moon.
• Set the head down, leaving the client in length.
• Clearly disengage.

Half Moon Vector through the Legs

Center yourself and your client (gently see if you can get the legs not to be too “turned out”)

• Contact the calcanei and calcaneal tendons with your

hands – take out the looseness between your hands and the calcanei and Achilles tendons.

• Take up the slack from the whole body and the

Achilles tendons.

• Add addi9onal vectors (the ”half moon”) by adding

slight addi9onal length while simultaneously going down, then back up (so it’s a clear and simple curved pull). You can also li+ the legs up a li1le if it feels be1er for the client or for your back.

• Hold it, Hold it, Hold it.
• Monitor for working signs (but don’t wait for one!)
• Clearly disengage, sepng the legs down in length.

96b Deep Massage: Guided Full Body